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Introduction: Endotoxins are one of the etiologic agents involved in the pathogenesis of apical periodontitis. The objectives of this clinical study were to investigate the effects of endodontic treatment by using different irrigants on endotoxins in root canals with pulp necrosis and apical periodontitis and to evaluate the cytotoxic effects.

Methods: Thirty-six root canals were selected. Samples were collected before (S1) and after instrumentation (S2). The root canals were divided into 3 groups (n = 12) according to the irrigant combination used: CLX + LW, 2% chlorhexidine gel + calcium hydroxide (0.14%, limewater); CLX + PmB, chlorhexidine + polymyxin B; CLX (control), chlorhexidine + saline. The third sampling (S3) was performed after ethylenediaminetetraacetic acid and S4 after intracanal medication (CLX + calcium hydroxide for 14 days). Endotoxins were quantified by the chromogenic Limulus amebocyte lysate assay, and cytotoxic effects were evaluated by the production of cytokines (interleukin-1ß, tumor necrosis factor α) in macrophages (RAW 264.7) stimulated with the root canal content.

Results: Endotoxins were detected in all root canals before instrumentation (S1). Group CLX + LW presented the greatest endotoxin reduction after instrumentation (99.18%), which was similar to group CLX + PmB (96.42%, P > .05) and different from group CLX (90.78%, P < .05). The intracanal medication promoted important endotoxin neutralization, with a reduction of 99.2% to 100%. The root canal content induced a higher production of tumor necrosis factor α and interleukin-1β in S1 samples compared with samples obtained after treatment.

Conclusions: The combination of CLX and limewater as irrigant was the most effective in reducing endotoxins in root canals, and intracanal medication was important to neutralize the cytotoxic effects.

Titel:	Efficacy of endodontic treatment for endotoxin reduction in primarily infected root canals and evaluation of cytotoxic effects.
Autor/in / Beteiligte Person:	Oliveira, LD ; Carvalho, CA ; Carvalho, AS ; Alves Jde, S ; Valera, MC ; Jorge, AO
Zeitschrift:	Journal of endodontics, Jg. 38 (2012-08-01), Heft 8, S. 1053-7
Veröffentlichung:	New York : Elsevier ; <i>Original Publication</i>: Chicago, American Dental Assocation, <1975-1982>., 2012
Medientyp:	academicJournal
ISSN:	1878-3554 (electronic)
DOI:	10.1016/j.joen.2012.04.015
Schlagwort:	Adult Animals Calcium Hydroxide therapeutic use Cell Line Chlorhexidine therapeutic use Edetic Acid therapeutic use Endotoxins antagonists & inhibitors Humans Interleukin-1beta analysis Limulus Test Macrophages drug effects Mice Middle Aged Polymyxin B therapeutic use Sodium Chloride Treatment Outcome Tumor Necrosis Factor-alpha analysis Young Adult Dental Pulp Cavity drug effects Dental Pulp Necrosis therapy Endotoxins analysis Gram-Negative Bacteria Periapical Periodontitis therapy Root Canal Irrigants therapeutic use Root Canal Therapy methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Language: English [J Endod] 2012 Aug; Vol. 38 (8), pp. 1053-7. <i>Date of Electronic Publication: </i>2012 Jun 08. MeSH Terms: Gram-Negative Bacteria* ; Dental Pulp Cavity / drug effects ; Dental Pulp Necrosis / therapy ; Endotoxins / analysis ; Periapical Periodontitis / therapy ; Root Canal Irrigants / therapeutic use ; Root Canal Therapy / methods ; Adult ; Animals ; Calcium Hydroxide / therapeutic use ; Cell Line ; Chlorhexidine / therapeutic use ; Edetic Acid / therapeutic use ; Endotoxins / antagonists & inhibitors ; Humans ; Interleukin-1beta / analysis ; Limulus Test ; Macrophages / drug effects ; Mice ; Middle Aged ; Polymyxin B / therapeutic use ; Sodium Chloride ; Treatment Outcome ; Tumor Necrosis Factor-alpha / analysis ; Young Adult Substance Nomenclature: 0 (Endotoxins) ; 0 (Interleukin-1beta) ; 0 (Root Canal Irrigants) ; 0 (Tumor Necrosis Factor-alpha) ; 451W47IQ8X (Sodium Chloride) ; 9G34HU7RV0 (Edetic Acid) ; J2VZ07J96K (Polymyxin B) ; PF5DZW74VN (Calcium Hydroxide) ; R4KO0DY52L (Chlorhexidine) Entry Date(s): Date Created: 20120717 Date Completed: 20130212 Latest Revision: 20181201 Update Code: 20231215

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Efficacy of endodontic treatment for endotoxin reduction in primarily infected root canals and evaluation of cytotoxic effects.